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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005439
Report Date: 01/29/2026
Date Signed: 01/29/2026 10:56:38 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/02/2021 and conducted by Evaluator Hanna Gough
COMPLAINT CONTROL NUMBER: 22-AS-20210302150320
FACILITY NAME:CARE JORDAN SENIOR HOMESFACILITY NUMBER:
306005439
ADMINISTRATOR:GIDEON LIMPIADOFACILITY TYPE:
740
ADDRESS:8728 CANARY AVENUETELEPHONE:
(562) 365-4155
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:6CENSUS: 6DATE:
01/29/2026
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Gideon LimpiadoTIME COMPLETED:
10:55 AM
ALLEGATION(S):
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Staff hit resident.
INVESTIGATION FINDINGS:
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Licesning Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to investigate the above mentioned complaint allegation. LPA was greeted and granted entry by staff. LPA met with Administrator (AD) Gideon Limpiado and discussed the purpose of the visit.

The investigation into the allegation of Staff hit resident revealed the following: It was alleged that Resident #1( R1) was hit on the coccyx by Staff #1(S1). LPA observed a physicians report for R1 dated April 4, 2021, that states that R1 was able to communicate their needs and was non ambulatory due to their physical condition.

The Department conducted interviews in March of 2021 with three residents in care. Three of three residents informed the Department that the staff take good care of them and assist with their needs. Two of three residents informed the Department that they have not been hit by facility staff, including R1.
LPA was unable to interview R1 due to no longer residing at the facility. Continue on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 22-AS-20210302150320
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: CARE JORDAN SENIOR HOMES
FACILITY NUMBER: 306005439
VISIT DATE: 01/29/2026
NARRATIVE
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The Department interviewed S1 and it was revealed that they never had any issues with the residents and denied the allegation.

Witness #1 (W1) informed the Department that they always saw S1 in a rush, but never rough with R1. Witness #2 (W2) informed the Department that S1 can be rough and always in a rush, but is good with R1.

AD informed LPA that S1 has not worked at the facility since sometime in 2022.

LPA interviewed current residents in care and one of six residents informed LPA that the staff are not rough with them and have not hit them. One of six residents did not confirm or deny the allegation and four of six residents were observed sleeping in their bedrooms or living room.

LPA observed current staff training for two of two staff on the topic of abuse and neglect in the elder care setting was last conducted on August 14, 2025.

Therefore, based on the interviews which were conducted and the records reviewed, the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the following allegation: Staff hit resident is deemed UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2